Displayed with permission from STAT
Older Americans who have paid into Medicare for years, may have to pay high premiums for health care until they hit eligibility.
Erika Snyder thought she was in the clear. An Obamacare policy covered surgery to remove a tumor from her lungs, leaving her with minimal costs for the $200,000 ordeal and a chance for a manageable semi-retirement.
But now, the 63-year-old Denver resident said she is not just worried about the cancer coming back. She’s afraid that passage of the House Republican’s plan to repeal Obamacare will leave her with no coverage if it does.
“I can’t imagine being in a situation where I’d have to get chemo,” said Snyder, who collects early social security and works part-time at a greenhouse. “I mean, what are we supposed to do?”
Just shy of Medicare eligibility, Snyder is part of the age 50 to 64 demographic that would face much higher insurance costs under the GOP plan, known as the American Health Care Act. The law would eliminate Obamacare subsidies that 3 million Americans in that age bracket currently rely on to purchase insurance. It would also allow insurers to charge older people up to 5 times as much as younger Americans for individual policies, while providing an age-based tax credit that experts say would fall far short of covering these additional costs.
Although the changes would be phased in over time, the nonpartisan Congressional Budget Office (CBO) predicts the law’s passage would have an immediate impact, causing 14 million people to lose coverage next year. By 2026, as the number of people losing coverage jumps to 24 million, premium costs for a 64-year-old would increase to $14,600 under the replacement plan, compared to $1,700 under the current law, according to the CBO.
The proposed legislation narrowly passed a committee vote Thursday amid opposition from conservative members who said it does not go far enough to dismantle Obamacare. It is expected to come up for a vote on the House floor next week.
Meanwhile, many older Americans, who have paid Medicare taxes for years on the promise of having that safety net down the line, are postponing retirement plans to cling to jobs that provide insurance coverage. For some who are staring down chronic diseases and other health problems, the costs of paying for health insurance before Medicare eligibility could undermine their financial stability before they even reach retirement age.
Peter Crowe, 50, is hoping to keep his teaching job, but he also suffers from Marfan syndrome, a genetic disorder that affects the body’s connective tissue and often leads to heart problems and an array of other complications. “I hope to stay employed until at least 65, but given my health condition, that may not be possible. It’s certainly a worry,” said Crowe, who is hopeful for one thing in the Obamacare fight. “There is also a big chance this (legislation) could implode.”
House Speaker Paul Ryan’s office did not respond to a request for comment on the bill’s impact on people between 50 and 64. But he and other Republican backers of the overhaul have argued the legislation would be phased in carefully and would allow more people to purchase the kind of coverage they want, free of mandates from Washington.
The provision allowing insurers to charge seniors five times more than younger Americans for coverage (current law allows a 3-to-1 ratio) is set to take effect in 2018, but it might not be reflected in premiums until 2019, the CBO says. In 2020, the law would would replace Obamacare’s cost-sharing subsidies – which are based on income and the actual cost of insurance in a person’s market- with a flatter, aged-based credit.
The GOP plan would provide the biggest credit, $4,000, to people over 60. But that amount would be much less than many seniors currently receive and would fall far short of covering the expected increase in premiums, making it hard for many people between 50 and 64 to afford coverage.
The AARP recently published a report that concluded low-income seniors would be hurt the most by the plan. Premiums for a 64-year-old making $15,000 would increase by nearly $8,400 under the Republican plan, the report found. Meanwhile, the tax credit changes would drop their financial assistance by as much as $5,900.
“How do you have an increase with those kinds of numbers? For some of these folks, I don’t see how they’ll be able to afford insurance,” said David Certner, legislative counsel for AARP.
For Mary Longcore, a 56-year-old Michigan resident who works in health care technology, the potential legislative changes create uncertainty. Longcore has Ehlers-Danlos Syndrome, an inherited disorder that can cause a wide array of medical issues, including unstable joints, chronic pain, and skin and eye problems.
She has excellent insurance coverage through her job at a university, but she knows she must keep it until age 62, when she will trigger employment provisions that give her insurance coverage after she retires. “If I go on disability at this point, I really don’t have enough to pay my bills and pay for whatever insurance I end up having to get,” Longcore said.
But for her, the political issue is far from black and white. She worries about her own coverage circumstances, but she also counts herself as a conservative and is concerned about the crushing costs of health care in the United States. She would like to see broader reforms, including changes that might help reduce the costs of prescription drugs.
“I’m holding out for hope here,” she said. “Because without hope we have nothing.”